My hips hurt (and so does my ankle!)! UPDATE

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MDNative
Regular Member


Date Joined Nov 2015
Total Posts : 160
   Posted 1/1/2017 9:27 PM (GMT -6)   
UPDATE AT THE END!

I apologize if most of this has been covered, but I feel like I'm at the point of physical exhaustion from the lack of an uninterrupted sleep for months!

Happy New Year to all, and please pardon my venting due to frustration. My prior posts have been in the Prostate Cancer area because, well, I'm just lucky like that! (BTW, that was all contained, just to rule that out).

Bilateral (and gradually worsening) hip pain for well over a year now, but my right side is, by far, the worse of the two. Unfortunately, being a natural side-sleeper, sleeping on either side tends to cause discomfort one way or another. My primary doc gave me an injection but with minimal, short-lived benefit, so off to the ortho I went with suspected bursitis. Xrays showed my hips actually looked really good (though odd where my prostate was. Helps explain why I was given a secondary screening at the airport!), so off to physical therapy I was sent. It didn't really offer relief. Heck, I even agreed to try 'dry needling' as barbaric as that sounds! The physical therapist advised me she thought it would be a good idea to see a different doc at the practice who's more of the 'hip guru' (and he works with the local college/pro teams) as she had some concern that I may have a labral tear. I saw him and it was off for a 3T MRI of my hips/gluteus area. I see him this Wednesday for a review of the MRI. And maybe ask about another injection.

When lying down, or pressing on the area with my fingers, my right side feels like there's a bad pressure point and sharp pain just about where the skin side of my pants pocket would be, but the pain radiates vertically along my outside thigh towards my knee, and sometimes beyond. Also, the inside of my right thigh/groin/right lap area kills me when I'm seated for more than a short period of time. Especially driving a car. On my left side it's pretty much just the pressure point I feel.

No conclusive idea what caused this. I took a hard fall when the East Coast had our 'snowmageddon' several years ago and I landed on my right side causing a rotator cuff tear and subsequent surgery in 2012. Maybe I injured my hip also and didn't know. I also have problems with my left ankle, which my podiatrist said looked to be arthritic in an xray (likely a childhood injury I'd forgotten about) which may have caused me to be 'off kilter' for many years. I'm sure wearing many pounds of gear and body armor until I retired from law enforcement was a big help, too (not to mention all the 'fun' involved!).

So, if I sleep on my right side, I get obvious pain. On my left side, I don't get too much contact pain, but if my right legs drop in front of my left, the pulling on the right side causes pain. If I sleep on my stomach I develop lower back pain, and on my back, I tend to snore and my wife kicks me, lol! I'm actually not a very good back sleeper anyways..... When all else is lost, I find my way to the recliner, and although I don't sleep great, at least it's not normally painful. I get a little relief if I can get the pillow to actually _stay_ between my knees all night, but good luck with that!

Ah...good times.

So, I'll see the ortho doc this week. He did mention that there are some surgical avenues available if necessary for both a tear and bursitis if need be. And even more physical therapy after that.....yahy!

Of course, I also have concerns that if my bad ankle was an underlying cause that'll eventually have to be addressed, but at the time, about 6 years ago, the foot doc was talking about fusions and such, and to me at that time, the surgery and recovery sounded worse than living with the problem (and I was still working). And once I was facing the RC surgery, and later the PC surgery, everything else was put on the back burner. I keep hoping if I can put it off long enough something better will come along for treatment.

Thanks for the space to rant, as I'm growing very weary of this situation. I swear, I feel like I'm 53 going on 94 sometimes!

Any thoughts are appreciated. I'll continue to search through these posts in the meantime.

Again, Happy New Year to all!

MD


UPDATE: So, the 3T MRI confirms bilateral bursitis, but also reveals a partial tear in the right gluteal area. Doc gave me 2 really fun lidocaine laced cortisone shots in each hip today, as well as an order to continue physical therapy. I see him again at 6 weeks. From what he said, surgery is the last resort and will require a long time on crutches. He also gave me hope that it's entirely possible that the shots will give me welcome relief and could do the trick. That would be awesome.....
51 yoa at Dx--Some family history of PCa
From 9/2013 to 3/2015 PSAs between 4.85 & 6.7, TRUS Bx-neg 12/2013, 12/2014 PCA3:38, 3/2015 switched from local urology group to Johns Hopkins, PSA 5.8/FPSA 17.4/PHI 28.4, 3/2015 mp3T MRI & Fusion-Guided Bx @ JH, 2/14 cores pos, Bilateral, <5% involvement, GL=6, RRP: 8/2015 @ JH (Dr. Carter)

Post surgical pathology – Upstaged to G7 (3+4), confined throughout. Margins, LN (11), SV, EPE, all negative. Additional findings: HGPIN

pT2C NO

PSA 11/2015 <0.1, 05/2016 <0.1, 9/2016 <.02 (new lab)

Post Edited (MDNative) : 1/4/2017 11:31:09 PM (GMT-7)


(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 665
   Posted 1/2/2017 12:22 AM (GMT -6)   
MDNative:
A labrial tear certainly would cause symptoms similar to what you are describing. Most labrial tears are due to simple aging of the tissue lining + recent trauma to the hip joint. Even mild trauma to the hip joint is enough to tear the already fragile and vulnerable labrial tissue.

The good news is that labrial tears are treatable.

There is a lot of growing interest in stem cell therapies for degenerative and traumatic hip dysfunction. It is considered cutting edge and, unfortunately, not widely available. But it might be worth your reading about and having the knowledge available to you. I am a firm believer that knowledge is power. The more you know about your condition and treatment options that are availing, the more active a participant you can be in working with your medical providers.

I have advanced avascular necrosis of both of my hips due to long-term corticosteroid use. The pain and loss of function is beyond description.

One of my medical providers is Dr. Renai. He is without a doubt brilliant. He founded an practice here in Portland, Oregon that focuses on functional orthopedic medicine, called Restore PDX (PDX is the moniker for the Portland airport). He is at the forefront of the developing field of stem cell therapies for joint disorders.

Here is the link to Dr. Renai's website, Restore PDX:

www.restorepdx.com

Read and browse through his articles on stem cell therapies.

Even if you do not use stem cell therapies now for your current hip dysfunction, it may be valuable to have knowledge of the growing science in the future.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

rocckyd
Veteran Member


Date Joined May 2012
Total Posts : 1082
   Posted 1/2/2017 6:39 AM (GMT -6)   
I hope your ortho appointment provides some sort of answer.

You mentioned dry needling. I've had this done off and on over years, and it did help quite a bit, but it took months to see any response. If an area was particularly difficult, e-stim was used with the needle in that area.

You will often feel sore and achy since the whole point is to make the muscle spasm, and then release.

You might want to give it a second chance.

Regardless, I hope you are able to get some answers to make each day better than the last.
Single mom to my little man 11yrs old
39yrs old. JRA since a kid. Chronic Uveitis, pleurisy, pericarditis, intersticial lung disease, sjorgrens syndrome, Cushing's Syndrome, gastroparisis
Bilateral TMJ replacements due to bone fusion, port-a-cath, g/j feeding tube, antiphospholipid antibody syndrome(my blood fights itself) epilepsy, MCTD, dysphagia(unable to swallow correctly)

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15005
   Posted 1/2/2017 9:37 AM (GMT -6)   
Welcome to the forum MDNative. I too will be curious as to what the orthopedic has to say. Hopefully you will get some answers.

If this visit provides no real information, then I suggest you talk to a dr about this hip pain coming from your back. Many people have experienced hip pain only to find out their back was the problem. At least its something to consider.

Please let us know what you find out.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

pitmom
Veteran Member


Date Joined Jan 2015
Total Posts : 2116
   Posted 1/2/2017 10:06 AM (GMT -6)   
Hello. I too have bursitis of both hips. Aleve usually helps me more than Advil.

What kind of shoes do you wear? This is really important. One summer, I was in excruciating pain in both hips. Turned out it was from wearing my flip flops nearly every day!

Try not to wear the same pair of shoes 2 days in a row. If you normally wear totally flat shoes, try something with a low heel for a day and then alternate. Some folks find relief from one or the other.

I worked as a cashier that wore an apron which I carried my 'life' in. Wallet, keys, work supplies, etc. The weight of it did not help my back or my hips, so I can relate to your utility belt issues.

As for a pillow while sleeping, have you tried strapping it to your leg?

Sometimes, when my hip is 'bad' I stand on that leg and raise the other behind me in one quick motion and it will pop. Sort of like cracking your knuckles on your fingers. Most of the time, the pressure gets relieved and I feel better.

Believe it or not, constipation and for women, menstruation can cause hip pain. How are your bowel movements?

I'm also looking forward to your mri results. The older I get (56 now) the more hip problems I've been having. If I do a lot of squatting down, cleaning or gardening, the worse my pain is. I take Aleve before I do those chores. An ounce of prevention is definitely worth a pound of cure!

MDNative
Regular Member


Date Joined Nov 2015
Total Posts : 160
   Posted 1/2/2017 7:57 PM (GMT -6)   
Thanks to all for the responses.

Seashell, Interesting stuff. And in Portland....Oh No! My wife and SIL got back from their first trip out that way last month and she's been teasing me about moving out there. "It's so beautiful!" Great. More ammunition for her! That's a long way from Annapolis! So sorry about your own ongoing hip issues.

Pitmom, I normally wear the same shoes--New Balance athletic shoes. The alternating heel thing is interesting. Thanks. I'll post again after the MRI with (hopefully) more news. I've thought about the pillow leg strapping, but I imagine falling trying to get to the bathroom in the middle of the night (the darn cats are a challenge enough!).

Straydog, one of the physical therapists took the back-related approach but it didn't seem to go anywhere. I really don't get the back pain unless on my stomach. Maybe the MRI will show something there if it's an issue.

Rocckyd, I wasn't particularly thrilled with the dry needling, but my PT provider said she has good results with it. I'm willing to give it more time, but I'll wait until I see if the MRI shows a tear.
51 yoa at Dx--Some family history of PCa
From 9/2013 to 3/2015 PSAs between 4.85 & 6.7, TRUS Bx-neg 12/2013, 12/2014 PCA3:38, 3/2015 switched from local urology group to Johns Hopkins, PSA 5.8/FPSA 17.4/PHI 28.4, 3/2015 mp3T MRI & Fusion-Guided Bx @ JH, 2/14 cores pos, Bilateral, <5% involvement, GL=6, RRP: 8/2015 @ JH (Dr. Carter)

Post surgical pathology – Upstaged to G7 (3+4), confined throughout. Margins, LN (11), SV, EPE, all negative. Additional findings: HGPIN

pT2C NO

PSA 11/2015 <0.1, 05/2016 <0.1, 9/2016 <.02 (new lab)

Post Edited (MDNative) : 1/2/2017 10:54:12 PM (GMT-7)


MDNative
Regular Member


Date Joined Nov 2015
Total Posts : 160
   Posted 3/3/2017 11:22 AM (GMT -6)   
So, a bit of an update on my hip pain. My physical therapist kicked me out, lol! Just kidding, but she doesn't believe it's benefiting me as it should by now. While I have much improved range of motion and strength in my hips/thighs now (not that it was all that bad for my age to begin with) the bottom line is that I'm still getting pain in my hips/right thigh and inner groin/lap area and she doesn't want me wasting my money. She also guessed correctly that I had a tear somewhere in there before my MRI confirmed it.

My doc's PA gave me another injection in each hip this past Wednesday. I wasn't looking forward to more needles, but I have to admit that she was right. She gives MUCH better needles than the doc does! I barely felt them! Awesomesauce!!! So, right now I'm feeling better. The PA thinks it would be a good idea to continue the stretching routines at home rather than go 'cold turkey' off of them, so I'll do that. Doctor follow-up in 6 weeks, where I imagine surgery to repair my gluteal tear and clean up the bursitis will be discussed if I'm still hurting. He told me before that the negative to surgery is the weeks of crutch time, and that it often takes 4-6 months to see the benefits resulting from the surgery. And of course, more PT! Great. Crutches to avoid bearing weight on my right leg/hip, while trying to get around using my left arthritic ankle for support....this just has "good times" written all over it, for sure!!!

So, for now hoping for a 'cortisone miracle' and if it doesn't work out, hopefully I can get through the summer before having to make a decision. Should it come to that, I'd rather deal with it in the Fall or Winter when I don't have work to do around the house so much.

I was just reading through these posts and thought I should update. Best wishes to everyone.

MD
51 yoa at Dx--Some family history of PCa
From 9/2013 to 3/2015 PSAs between 4.85 & 6.7, TRUS Bx-neg 12/2013, 12/2014 PCA3:38, 3/2015 switched from local urology group to Johns Hopkins, PSA 5.8/FPSA 17.4/PHI 28.4, 3/2015 mp3T MRI & Fusion-Guided Bx @ JH, 2/14 cores pos, Bilateral, <5% involvement, GL=6, RRP: 8/2015 @ JH (Dr. Carter)

Post surgical pathology – Upstaged to G7 (3+4), confined throughout. Margins, LN (11), SV, EPE, all negative. Additional findings: HGPIN

pT2C NO

PSA 11/2015 <0.1, 05/2016 <0.1, 9/2016 <.02 (new lab)

Post Edited (MDNative) : 3/4/2017 9:40:34 AM (GMT-7)


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15005
   Posted 3/4/2017 7:47 AM (GMT -6)   
I sure hope the injections are going to work for a long time. I cannot imagine being on crutches that long. I had to use them twice for 6 week intervals & it was terrible. I was fitted & trained on how to use them but it was a disaster for me, lol. I have a horrible fear of needles & you are so right, not everyone knows how to do injections.

Please keep us posted on how you are doing.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 665
   Posted 3/4/2017 8:45 AM (GMT -6)   
Crutches, truly, are only for the young.

I would not advocate anyone using crutches for the length of time that you are quoting (4-6 months) who is older than 30 years of age - and I am a physical therapist.

The better option is a front-wheeled walker or a 4-wheeled walker (these typically have a folding seat and front brakes on the handlebars). The benefits are many: 1. Stabilized balance; 2. More normal step sequencing owing to the broader base of support provided by a walker; 3. Less fall risk; 4. Improved weight distribution on the healthy supporting arms and unaffected leg.

Physicians are not the best judge of using crutches. Physicians toss out the word "crutches" as a generalist term for any assistive walking device, similar to using the word "Kleenex" for facial tissue.

I would encourage you to source a front-wheeled walker (normally provided by medical insurance through a policy's durable medical equipment benefits, rental or purchase) or a 4-wheeled walker (not typically covered by medical insurance, these walkers generally require private payment and cost about $175 or more new; used 4-wheeled walkers are often available on e-bay and some pharmacies).

Walkers are not just for the elderly. Walkers are the better choice for most individuals older than 30. I have a junior-sized 4 wheeled walker, myself. Bright blue color. I love it. I am 56 years of age.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

MDNative
Regular Member


Date Joined Nov 2015
Total Posts : 160
   Posted 3/4/2017 10:51 AM (GMT -6)   
Thanks Karen. To clarify, I think I'd need walking assistance for about 2 months post surgery, not the entire 4-6 months. That said though, you may be right regarding the walker. My wife suggested that option and has recently purchased a 4-wheeled version w/seat and handbrakes for her 83 year old father who's been having gait issues due to a previous spinal injury. He seems to be getting the hang of it (his pride aside!). I was thinking, if nothing else, maybe one of those 'knee carts' that keep one leg off the ground as we scoot about. We'll see. I'm still hoping for that 'cortisone miracle!'

And Susie, lol on the 'disaster.' Not literally, of course, but I can only see images of myself in awkward situations with crutches protruding from places they shouldn't even be in to begin with!

MD
51 yoa at Dx--Some family history of PCa
From 9/2013 to 3/2015 PSAs between 4.85 & 6.7, TRUS Bx-neg 12/2013, 12/2014 PCA3:38, 3/2015 switched from local urology group to Johns Hopkins, PSA 5.8/FPSA 17.4/PHI 28.4, 3/2015 mp3T MRI & Fusion-Guided Bx @ JH, 2/14 cores pos, Bilateral, <5% involvement, GL=6, RRP: 8/2015 @ JH (Dr. Carter)

Post surgical pathology – Upstaged to G7 (3+4), confined throughout. Margins, LN (11), SV, EPE, all negative. Additional findings: HGPIN

pT2C NO

PSA 11/2015 <0.1, 05/2016 <0.1, 9/2016 <.02 (new lab)

Post Edited (MDNative) : 3/4/2017 8:00:46 PM (GMT-7)


(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 665
   Posted 3/4/2017 7:13 PM (GMT -6)   
MDNative:

FYI . . If you are having hip surgery (bursa and labrum tear repair), a "knee cart" would not be a good option as a knee cart requires full weight bearing through the hip and femur - allowing for unweighting of the tibia and ankle and foot. A knee cart unweights the shin/lower leg but does not unweight the hip and thigh/upper leg.

Modern walkers are not the old clunkers that people tend to associate with walkers of years ago. Even the non fancy, entry-level front wheeled walker has been renovated and updated. Some of the 4-wheeled walkers are pretty sporty - complete with an under the seat storage bin and pneumatic tires and pivoting front wheels.

Personally, I feel no shame or embarrassment being out and about with my junior-sized 4 wheeled walker. It is all about forming a positive mind-set.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)
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